Taking a high-level view to new horizons

Speaking at the event, “Future Developments in Healthcare Estates”, staged on the top floor of London’s BT Tower, RIBA president and Penoyre & Prasad senior partner Sunand Prasad told an audience largely comprising architects, designers and building consultants that, while with recent years’ substantial public investment in the UK healthcare estate, “things were improving, it doesn’t always feel like that”. While GDP spending per capita in the UK on healthcare had now caught up with many European countries, the RIBA president argued that much of the public healthcare estate was “still suffering the legacy of years of neglect”, to the extent that some healthcare providers would be “loathe to admit” to the standard of some of the accommodation still used to house patients. More positively, with increasing evidence of the significant impact that well thought out and designed healing environments could have on patient recovery, good practice in hospital design was becoming more widespread, with a better evidence base on which to draw. Providing patients with views of nature while in hospitals had, for instance, been shown empirically for some time to help reduce reliance on analgesics post-surgery, and to help combat depressive illness, but such conclusions were now increasingly being backed by hard scientific study evidence.

Bringing the outside in

Sunand Prasad said: “Bringing the outside world into the building and using warm, natural surfaces like timber, as well as sinuous surfaces and finishes, can have a really dramatic effect on the quality and ambience of the healing environment, meaning a hospital need not, in many ways, feel like a conventional healthcare building at all.” Carefully commissioned artwork and innovative exterior and interior design features not normally associated with clinical environments could also, he said, make hospitals feel “less oppressive and more inspiring”. He cited as a good example the Richard Desmond Children’s Eye Centre at London’s Moorfields Hospital (HEJ – January 2008), an awardwinning Penoyre & Prasad-designed building where features include a waiting area with a translucent-coloured quiet pod, which “bursts” through to the floor above, internal “bridges” that cross a slot of space running up the building and separate the lift and stairs that “act as an area of pause” for patients prior to them entering clinical areas, and, externally, and most distinctively, a striking glass façade with a flowing pattern of aluminium solar control louvre blades – inspired by the idea of a wheeling flock of birds. The effect is made even more spectacular at night when the louvres are illuminated by different-coloured lighting. While architects would, he believed, continue to harness existing best practice to develop new acute hospital facilities that meet increasing patient expectations for buildings with “a hotel, rather than a hospital-like environment”, the RIBA president stressed that the growing shift of more and more care to primary settings would bring its own challenges for the profession. Seventy-five per cent of the UK healthcare budget was, he said, already going into primary care, meaning a “major reconfiguration of existing cultures and practices”. He added that 10 times as many medical episodes are dealt with in the home than in primary care institutions, which in turn account for nine-tenths of all institutional healthcare. In future, he believed that admitting a patient to hospital would increasingly be seen as “a last resort”.